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5/8/2014
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How Indiana Hospital Contained MERS Outbreak

Community Hospital used EMR, video surveillance, and real-time tracking technology to isolate the first known US case of the potentially deadly virus.

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When a patient at Indiana's Community Hospital tested positive for MERS, the healthcare provider's combination of technologies and best-practices ensured the potentially deadly virus did not spread to other patients, employees, or the community.

Despite being the first US encounter with MERS -- Middle East Respiratory Syndrome -- this is not the Munster, Ind., hospital's first brush with a highly contagious respiratory infection. The 427-bed facility, which usually runs at 100% capacity, has a department dedicated to infectious diseases, said Dr. Alan Kumar, chief medical information officer, in an interview. This team stays current on best-practices across the country and world, and ensures any contagious patients remain isolated.

So when a patient arrived from Saudi Arabia with symptoms of MERS, including severe fever, cough, and shortness of breath, Community Hospital relied on its standing procedures and policies, plus various technology investments, to prevent the infection from spreading, Dr. Kumar told us. About half the people infected with MERS die from the disease, which was discovered in 2012, according to the World Health Organization. To date, approximately 401 people have been infected, the Centers for Disease Control and Prevention reports.

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Community Hospital's technology investments helped prevent that number from growing. Staff, patients, and visitors wear badges equipped with real-time locating system (RTLS) technology. Developed by Versus Technology, the RTLS badges allowed Community Hospital to quickly identify who had come into contact with the infected patient and test them for MERS, said Dr. Kumar.

All 50 individuals tested negative, but the hospital sent them home for 14 days, where they are checked daily, said Don Fesko, CEO of Community Hospital, at a news conference on May 5. They are not contagious to family, and the CDC had said they could return to work, if masked, but the hospital opted to be overly cautious, said Dr. Kumar. After two weeks they'll be retested; if, as expected, they test negative, they can return to work, he noted.

In addition to the RTLS system, Community Hospital relied on its electronic medical records to determine who had visited or assisted the infected patient, Dr. Kumar said.

"Every interaction with a patient is logged into the EMR. We keep an active log of every interaction -- even when housekeeping goes into a room, just to keep a running flow. When you run this many beds, you need a very sophisticated flow dynamic system."

The hospital also checked its video surveillance system, installed as additional security for staff, visitors, and patients, to ensure it had not missed anyone potentially at risk of infection, said Dr. Kumar.

"Our hospital has very stringent standard protocols for any patient with infectious diseases. We do frequent education and frequent checks. That's the best way to prevent infections from spreading."

As a result of its success in limiting the first known case of MERS to reach the US, Community Hospital and the CDC are working on a paper to share best-practices with other hospitals and practices, according to Dr. Kumar.

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Alison Diana has written about technology and business for more than 20 years. She was editor, contributors, at Internet Evolution; editor-in-chief of 21st Century IT; and managing editor, sections, at CRN. She has also written for eWeek, Baseline Magazine, Redmond Channel ... View Full Bio

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Alison_Diana
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Alison_Diana,
User Rank: Author
5/8/2014 | 5:14:17 PM
Laying a Foundation
It's good to know that Community Hospital had such terrific measures in place to deal with infectious diseases. I wonder whether all hospitals have similar procedures -- and how a lack of EHRs in some places (about 7% by last reckoning) affects those plans? It's a small percentage, but a big number if that's the institution affected by an outbreak...
Alison_Diana
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Alison_Diana,
User Rank: Author
5/14/2014 | 10:22:50 AM
Second case in Orlando
A second case of MERS was discovered in Orlando, Fla., this week. In this case, MERS spread to at least one hospital worker. Twenty employees and others in contact with the index patient have been quarantined, according to local media. I don't know how the Orlando hospital determined who had come into contact with this original patient. 
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